Volume 10, Number 5—May 2004
Dispatch
Mycobacterium africanum Cases, California
Edward Desmond*
, Ameena T. Ahmed*, William S. Probert*, Janet Ely*, Yvonne Jang*, Cynthia A. Sanders*, Shou-Yean Lin*, and Jennifer Flood*
, Ameena T. Ahmed*, William S. Probert*, Janet Ely*, Yvonne Jang*, Cynthia A. Sanders*, Shou-Yean Lin*, and Jennifer Flood*Table 1
Clinical characteristics of patients with Mycobacterium africanum disease
| Patient | Demographic characteristics | Signs and symptoms | Clinical characteristics | Treatmenta | Outcome |
|---|---|---|---|---|---|
| A |
25-y-old black South African man with recent travel to West Africa |
3 months’ productive cough, weight loss, and low-grade fever |
Large left upper lobe infiltrate on chest radiograph |
INH, rifampin, PZA, and ethambutol by directly observed therapy for 6 months |
Resolution of symptoms and improvement of chest radiograph |
| B |
34-y-old black West African woman recently arrived in U.S. with metastatic carcinoma, treated with chemotherapy one year prior to presentation. |
2 months’ cough, fever, night sweats, fatigue |
Right lower lobe cavitation, streaky infiltrates bilaterally on chest radiograph, normocytic anemia |
INH, rifampin, PZA, and ethambutol by DOT |
Sputum culture negative after 2 weeks of therapy. Only modest improvement in chest radiograph. Returned to West Africa after 4 months DOT |
| C |
26-y-old black South African, immigrated to U.S. 2 y before diagnosis |
Unknown |
Cavitary lesion on chest radiograph |
INH, rifampin, PZA, and ethambutol by DOT for 6 months |
Sputum culture and smear negative, chest radiograph improved |
| D |
26-y-old Vietnamese man, immigrated to U.S. 6 y before diagnosis. No history of travel to Africa or African contacts with tuberculosis |
2 weeks’ productive cough, positive PPD |
Unknown |
Capreomycin, ofloxacin, PAS, clofazamine, and cycloserine for 2 y by DOT |
Sputum smear and culture converted to negative, symptoms resolved. Free of disease 2 y after therapy completed |
| E | 27-y-old U.S.-born black man with no known risk factors for tuberculosis infection. No history of travel to Africa or African contacts with tuberculosis | 2 months’ anorexia and weight loss; 1 month of cough and night sweats; 1 week of fever and abdominal pain | Normal chest radiograph results. Pancreatic cyst and fullness of left psoas muscle on CT scan | INH, rifampin, PZA, and ethambutol for 10 months by DOT | Symptoms resolved. Free of disease 1 y after therapy completed |
aINH, izoniazid; PZA, pyrazinamide; DOT, directly observed therapy; CT, computerized tomography, PPD, purified protein derivative; PAS, para-aminosalicylic acid.
